Training Pathways for Minimally Invasive Gynecologic Surgery: An Analysis of Residencies and Matched FMIGS Trainees.

OBJECTIVE

To better understand the training environment in Minimally invasive Gynecologic Surgery (MIGS) among obstetrics and gynecology (OBGYN) residency programs and the educational pathway to securing an FMIGS (Fellowship in MIGS) fellowship.

DESIGN

Observational, cross-sectional study utilizing data from the Accreditation Council for Graduate Medical Education (ACGME) for OBGYN residency programs and both ACGME- and AAGL-accredited gynecologic fellowships. Outcomes included the proportion of residency programs with affiliated FMIGS fellowships or MIGS divisions, the number of FMIGS fellows who trained at such programs, and trends in residency-to-fellowship transitions over a five-year period.

SETTING

Not applicable as this was a survey study for all residency programs in the United States.

PARTICIPANTS

All United States-based ACGME-accredited OBGYN residency programs and ACGME- and AAGL-accredited gynecologic fellowships from 2022 to 2026 were included. FMIGS fellows were identified using publicly available annual match lists published by the AAGL for fellowship years 2022 to 2026.

RESULTS

Among 298 OBGYN residency programs, 46 (15%) had an affiliated FMIGS fellowship, less than gynecologic oncology (n = 74), Urogynecology and Reconstructive Pelvic Surgery (URPS) (n = 58) and Reproductive Endocrinology and Infertility (REI) (n = 51). Another 22 residency programs (9%) had a co-located MIGS division without a fellowship. From 2022 to 2026, 227 residents matched into FMIGS fellowships. Of these, 53% trained at residencies with FMIGS programs, and 9% trained at residencies with MIGS divisions but no co-located FMIGS fellowship. In total, 35% of residency programs had at least one resident match into FMIGS during the study period, indicating variability in program output.

CONCLUSIONS

Overall, residency programs with co-located FMIGS fellowships or MIGS divisions appear to enhance fellowship match success.